2022-08-10T11:02:07-05:00 2021-09-30 990 2020-10-01 454456939 Hartford HealthCare Medical Group Inc HART 8606966200 1290 Silas Deane Highway 2nd Floor Wethersfield CT 06109 Mark Keise Authorized Signer 8606966282 2022-08-10 Mark Keise 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Cynthia Heller 1290 Silas Deane Highway 2nd Floor Wethersfield CT 06109 160804652 0 X www.hartfordhealthcaremedicalgroup.com X 2012 CT The Mission of Hartford HealthCare Medical Group is to put the patients first, provide coordinated quality care and value, exceed the expectations of patients, providers, staff and the community that it serves. 4 0 3609 0 0 0 169219 0 202677404 160322371 -47905 -56022 554798 482281 203353516 160748630 0 0 0 0 94826430 101124559 0 0 0 108512489 59613049 203338919 160737608 14597 11022 153642839 148658102 115898745 134597864 37744094 14060238 X The Mission of Hartford HealthCare Medical Group is to put patients first, provide coordinated quality care and value, and exceed the expectations of patients, providers, staff and the community that it serves. 0 0 10121315 9342003 The Primary Care program under Hartford HealthCare Medical Group has 164 physicians and 152 advanced practitioners who provide primary care across the State of Connecticut. Physicians have privileges at Hartford Hospital, Hospital of Central Connecticut, MidState Medical Center, Windham Community Memorial Hospital, Backus Hospital, Charlotte Hungerford Hospital and St. Vincent's Medical Center. The practices saw 737,062 patient visits in 2021. Our providers are credentialed in both internal and family medicine, with a commitment to providing sick visits within 24 hours. Within our Hartford HealthCare Medical Group Primary Care practices, our largest practices from a financial standpoint are our primary care practices in West Hartford, Avon and South Windsor which are located in various regions across Connecticut. 133252311 150980368 Hartford HealthCare Medical Group (HHCMG) is a multi-specialty group encompassing providers located throughout the state of Connecticut. In addition to clinical practice, our doctors are teachers and researchers, always looking for ways to improve the quality of care and bring innovations to their patients.Hartford HealthCare Medical Group has more than 300 primary care providers located throughout the state of Connecticut. HHCMG offers Primary Care, Urgent Care and Walk-in services. We are a member of Hartford HealthCare and are affiliated with some of the region's top hospitals including Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center, Windham Hospital, Backus Hospital, Charlotte Hungerford Hospital and St. Vincent's Medical Center. 133252311 150980368 143373626 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 202 0 1 3609 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Baranick 8606962546 181 Patricia M Genova Drive Newington CT 06111 Sabet Hashim MD Physician 60.00 0.00 X 1539188 0 79417 Vincent DiBattista Former Director & Presiden 0.00 60.00 X 0 1230973 82821 Michael Daglio Director 1.00 59.00 X 0 1347033 187529 Brendan Killory MD Neurosurgeon 60.00 0.00 X 1335220 0 76536 Daniel Fusco MD Cardiothoracic Surgeon 60.00 0.00 X 1219757 0 76413 Jeffrey Cohen MD Chair 2.00 58.00 X X 0 1154707 92708 Rafael Squitieri MD Chief Card Thoracic 60.00 0.00 X 1106067 0 79764 Robert Hagberg MD Chair Dept Cardiac Surgery 60.00 0.00 X 1111009 0 72031 Mark Prete Vice Chair & President 30.00 30.00 X X 665823 0 109743 Cynthia Heller Director 1.00 59.00 X 491850 0 52685 David Baranik VP, Finance 30.00 30.00 X 0 375120 72404 Mark Vye VP, Specialty Care Ops. 30.00 30.00 X 352585 0 62078 Susan Barrett VP, Primary Care Ops. 30.00 30.00 X 363361 0 37039 Carla Nunziante VP, Growth & Acquisitions 30.00 30.00 X 299148 0 66282 Brian Miller VP, Human Resources 30.00 30.00 X 0 215850 27466 8484008 4323683 1174916 1118 1 1 0 Physician Alliance of Connecticut LLC 322 East Main Street Branford CT 06405 Medical Services 5867031 FIP Construction Inc 1536 New Britain Avenue Farmington CT 06032 Construction Services 1514705 Propicius BioSolutions LLC 10 Jordan Lane Unionville CT 06085 Staffing Services 1204183 J Morrissey & Company Inc 289 Broad Street Windsor CT 06095 Staffing Services 994268 CDW LLC 300 North Milwuakee Avenue Vernon Hills CT 60061 Information Technology Services 926679 30 Net Patient Care 624100 160322371 160322371 160322371 482281 0 482281 482281 482281 56022 -56022 -56022 -56022 160748630 160322371 0 426259 X 2279804 1067893 1211911 82819118 75145623 7673495 3699227 3365662 333565 6923376 6299085 624291 5403034 4816012 587022 51019 51019 65855 65855 28448547 28448547 5950 5950 932291 567159 365132 2740372 1759419 980953 10178151 9251888 926263 230701 128255 102446 247818 236049 11769 9030 5328 3702 4254487 1472970 2781517 2249648 2161859 87789 1618861 1471554 147307 Medical Supplies 7138285 5762645 1375640 Repairs & Maintenance 950750 927375 23375 Dues, Subs & Licenses 489996 479617 10379 Misc Expense 1271 720 551 17 16 1 160737608 143373626 17363982 0 8164511 8584549 15644465 14808800 2705933 607560 3226623 504133 31372759 11659730 29444061 19713029 94457246 104440031 153642839 148658102 14580624 27540608 101318121 107057256 115898745 134597864 X 37741794 14057938 2300 2300 37744094 14060238 153642839 148658102 X 11022 -23694878 X 0 1 X 1 1 1 X 163246 167417 169219 0 499882 140775450 269528557 286593882 202677403 160322371 1059897663 140775450 269691803 286761299 202846622 160322371 1060397545 0 0 0 1060397545 319442 570809 594898 554798 482281 2522228 319442 570809 594898 554798 482281 2522228 141094892 270262612 287356197 203401420 160804652 1062919773 0.99760 0.99800 0.00240 0.00200 X 1 1 65855 65855 0 Part II-B, Line 1: Hartford HealthCare Medical Group, Inc. paid annual dues to CT Community Nonprofit Alliance and to Connecticut Hospital Association (CHA). CHA conducts lobbying activities on behalf of its members. CHA allocates a portion of their dues as lobbying expenses. The portion of dues allocated as lobbying expenses is calculated under current Medicare rules. CHA conducts lobbying activities under current Medicare rules. The Organization occasionally asks its employees to volunteer their time to contact state legislators in an effort to lobby on its behalf. The total amount of dues allocated for lobbying expenses for FY21 was $65,855. 13897363 4642569 9254794 10651192 7017161 3634031 6824204 6824204 19713029 Other Assets - Operating Lease 35935650 Malpractice Insurance 32487251 SERP Asset 23478228 Due from Affiliates 12470759 Security Deposits 68143 104440031 Other Liabilities - Opearting Lease 47200728 Accrued Malpractice Insurance 32487251 Accrued Pension Plan 23478228 Patient Refunds 3891049 107057256 South Asia 0 0 Program Services Indexing Services 36004 0 0 0 0 0 0 36004 0 36004 0 0 0 0 0 0 Part III Accounting Method: Sch F, Part II, Line 1 The indexing services are being recorded on cash basis. 0 1 0 0 0 0 0 1 0 Sabet Hashim MD Physician 1287473 0 250000 0 1715 0 19950 0 59467 0 1618605 0 0 0 Vincent DiBattista Former Director & Presiden 0 609861 0 262619 0 358493 0 19950 0 62871 0 1313794 0 248914 Michael Daglio Director 0 754236 0 586725 0 6072 0 122843 0 64686 0 1534562 0 0 Brendan Killory MD Neurosurgeon 1296924 0 660 0 37636 0 19950 0 56586 0 1411756 0 0 0 Daniel Fusco MD Cardiothoracic Surgeon 1188921 0 6600 0 24236 0 19950 0 56463 0 1296170 0 0 0 Jeffrey Cohen MD Chair 0 679045 0 350046 0 125616 0 19950 0 72758 0 1247415 0 0 Rafael Squitieri MD Chief Card Thoracic 1060942 0 44573 0 552 0 19950 0 59814 0 1185831 0 0 0 Robert Hagberg MD Chair Dept Cardiac Surgery 958229 0 113100 0 39680 0 19950 0 52081 0 1183040 0 0 0 Mark Prete Vice Chair & President 479038 0 180845 0 5940 0 77258 0 32485 0 775566 0 0 0 Cynthia Heller Director 376351 0 112408 0 3091 0 19950 0 32735 0 544535 0 0 0 David Baranik VP, Finance 0 239762 0 131714 0 3644 0 19950 0 52454 0 447524 0 0 Mark Vye VP, Specialty Care Ops. 276397 0 72683 0 3505 0 19950 0 42128 0 414663 0 0 0 Susan Barrett VP, Primary Care Ops. 287854 0 73107 0 2400 0 19950 0 17089 0 400400 0 0 0 Carla Nunziante VP, Growth & Acquisitions 234491 0 62538 0 2119 0 19950 0 46332 0 365430 0 0 0 Brian Miller VP, Human Resources 0 195146 0 20301 0 403 0 15081 0 12385 0 243316 0 0 Part I, Line 3 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Hartford HealthCare Medical Group, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher, to determine best practices in governing executive compensation. Please refer to compensation narrative reported on Schedule O. Part I, Line 4b Hartford Healthcare Corporation, a related organization, maintains a 457(f) Supplemental Executive Retirement Plan (SERP). Participants include certain officers and key employees at the President & CEO, Executive Vice President and Senior Vice President levels that are reported by Natchaug Hospital, Inc. on its Form 990, Part VII. Contributions are made by Hartford HealthCare Corporation to the plan based on a percentage of the participant's compensation. Participants vest in the plan at the earlier of reaching age 55 and having 5 years of service, death, disability, involuntary separation without reasonable cause, upon reaching age 65 or the occurrence of a change in control. Each participant ceases to be eligible for further contributions by Hartford Healthcare Corporation on the date of the participant's separation from service. Participants receive a one-time lump sum payment of the accumulated amount during the 30-day period following the participant's separation from service. 2020 SERP Accruals were made on behalf of the following individuals: Michael Daglio $102,893 Mark Prete $57,308 2020 SERP Payouts were made on behalf of the following individuals: Vincent DiBattista $105,373* Jeffrey Cohen $28,914* *For these individuals, vesting occurred, causing taxable income. This portion of the vested amount was used to pay the associated tax liability. The remaining balance was deposited into the employee SERP account. Part I, Line 7 Hartford HealthCare Corporation, a related organization, has a Compensation At Risk Plan that encourages and rewards achievements of significant functional goals. These goals contribute to the organization's strategic and financial direction. The plan utilizes market practice alignment to ensure competitive recruitment and retention. Awards are based on CEO and/or Hartford HealthCare Corporation's Compensation Committee discretionary assessment of overall organization performance and individual contribution to results. Form 990, Part VI, Section A, line 1 The organization does not have any independent board members as all board members are compensated for their service to the organization either by the organization itself or by a related organization - HHC. The Foundation is a member of an integrated healthcare delivery system which includes multiple tax-exempt hospitals that have community boards. Form 990, Part VI, Section A, line 6 Hartford HealthCare Medical Group, Inc. is organized as a non-stock not for profit entity. Hartford HealthCare Corporation is the sole member. Form 990, Part VI, Section A, line 7a The sole member of the organization has the authority to approve/remove members of the governing body. Form 990, Part VI, Section A, line 7b The sole member of the organization has the right to review, approve, disapprove and deny significant transactions such as mergers, acquisitions, dissolutions etc. Form 990, Part VI, Section B, line 11b The Form 990 was prepared by Hartford HealthCare's Tax Department. It was then forwarded to the the VP of Finance for review. The final Form was provided to the entire Board prior to submission to the Internal Revenue Services (IRS). Once the entire review process was completed, the Form was signed and then filed with the IRS. Form 990, Part VI, Section B, line 12c The Hartford HealthCare Medical Group, Inc.'s board has adopted the policy of the member, Hartford HealthCare Corporation (HHC). HHC's Conflict of Interest Policy (Policy) requires all covered individuals, including board members and officers, to provide a disclosure of relationships that create or have the appearance of creating a conflict of interest or commitment. The Policy requires updates if changes in circumstances arise during the year that either (a) create a new potential conflict of interest or commitment or (b) change or eliminate a conflict of interest or commitment previously disclosed. Conflict of interest disclosure statements are maintained by the HHC Office of Compliance and Integrity (OCI). Employee disclosures are reviewed by OCI in collaboration with the Covered Individuals' supervisor when deemed appropriate, to determine if there is a potential conflict. Oversight review of employee disclosures is provided by the HHC Conflict of Interest Committee. The Conflict of Interest Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Oversight review of physician disclosures is provided by the HHC Physician Conflict Resolution Committee. The Physician Conflict Resolution Committee assesses and may recommend the conflicting interest either be (a) eliminated for continued relationship with HHC/HHC Affiliate, or, (b) managed through a management plan. Board member disclosures are reported to the HHC Nominating and Governance Committee for determinations of conflicts and the management of them, where applicable. Form 990, Part VI, Section B, line 15 The Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare on behalf of Natchaug Hospital, Inc., hires an outside consultant, Human Resources and Compensation Consulting Practice of Gallagher to determine best practices in governing executive compensation. The following steps were taken: - The use of an Independent Executive Compensation Committee (Committee) of the Board of Directors of Hartford HealthCare, on behalf of Natchaug Hospital, Inc., established and regularly reviews Executive Compensation Philosophy; - The Committee regularly reviews scope and depth of positions taking into account complexity and the financial impact and accountability of all "disqualified persons; - National peer groups are selected for comparative purposes based on organizational size, operating revenue, geography and other relevant factors; - Analysis of current total compensation versus market is performed by independent third party compensation consulting firm and is then reviewed by the committee; - Recommendations are made based on market data analysis to ensure appropriate competitive positioning within parameters of compensation philosophy; -The President & CEO compensation is reviewed by the Committee and is based on comparative market information and organizational performance; - All changes are reviewed and approved by the Executive Compensation Committee; The compensation determination process for the President & CEO is reviewed on an annual basis. All other executive compensation is regularly reviewed for scope and depth of positions taking into account complexity and the financial impact and accountability. Form 990, Part VI, Section C, line 18 The Organization's Form 990, Form 990-T, Form 1023 and its attachments are available for public inspection at the organization's address upon request. Form 990, Part VI, Section C, line 19 The Organization's Financial Statements, Governing Documents and the Conflict of Interest Policy are available for inspection upon request at the Organization's address. Form 990, Part IX, line 11g Medical Professional Fees: Program service expenses 28,448,547. Management and general expenses 0. Fundraising expenses 0. Total expenses 28,448,547. Form 990, Part XI, line 9: Transfer to Affiliated Entities -23,694,878. HHC Urgent Care Centers LLC 1290 Silas Deane Highway 2nd FL Wethersfield CT 06109 300993315 Outpatient Care Clinic CT Hartford HealthCare Medical Group Inc Backus HealthCare Inc 326 Washington Street Norwich CT 06360 222481794 Supporting Organization CT 501(c)(3) 12 (a) Hartford HealthCare Corporation 1 Connecticut Health System Inc 80 Seymour Street Hartford CT 06102 222779421 Coordination of Health Care Delivery CT 501(c)(3) 12 (c) Hartford HealthCare Corporation 1 Hartford HealthCare ACO Inc 1290 Silas Deane Hwy 2nd Floor Wethersfield CT 06109 460886367 Government Contracts CT 501(c)(3) 7 Hartford HealthCare Medical Group Inc 1 Hartford HealthCare at Home Inc 1290 Silas Deane Hwy Suite 4B Wethersfield CT 06109 060646938 Home Healthcare CT 501(c)(3) 10 Hartford HealthCare Corporation 1 Hartford HealthCare Corporation One State Street Suite 19 Hartford CT 06102 222672834 Support & Management Svcs. 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0 0 0 1 1 0 1 1 1 1 1 Charlotte Hungerford Hospital O 111723 FMV Hartford Hospital C 84103 FMV Hartford Hospital R 1817670 FMV Hartford Hospital P 669867 FMV Hartford Hospital A 177218 FMV Hartford Hospital O 545493 FMV Hartford Hospital R 321960 FMV Hartford Hospital M 298695 FMV Hartford Hospital S 171424 FMV HHCMG Specialists B 84103 FMV HHCMG Specialists A 143058 FMV HHCMG Specialists M 715855 FMV HHCMG Specialists R 589459 FMV HHCMG Specialists S 24576843 FMV HHCMG Specialists Q 396330 FMV Hospital - Central Connecticut O 312675 FMV Midstate Medical Center O 62137 FMV St Vincent's Medical Center L 121220 FMV The William Backus Hospital P 56109 FMV The William Backus Hospital L 506828 FMV The William Backus Hospital S 122005 FMV Windham Community Memorial Hospital S 385075 FMV Windham Community Memorial Hospital P 106310 FMV Windham Community Memorial Hospital O 67538 FMV Hartford Hospital R 364711 FMV